| NPI | 1851689517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME166508) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 31854) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2024-04-25 |