| NPI | 1639464811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME135468) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MDR-6193) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2024-02-07 |