| NPI | 1679559512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME80087) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME80087) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-10-08 |