| NPI | 1811977879 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME 61977)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME61977)  | 
| Enumeration Date | 2006-01-18 | 
| Last Update Date | 2017-03-13 |