| NPI | 1669464574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME47155) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL 47155) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2022-06-21 |