| NPI | 1831197623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME94751) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME94751) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2014-04-15 |