| NPI | 1720289481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME108093) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL TRN11026) |
| 208000000X Pediatrics (Licence: AZ 46847) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2013-10-16 |