| NPI | 1740577238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME135325) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A114293) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2019-08-27 |