| NPI | 1609050293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME134151) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 048900) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2019-05-28 |