| NPI | 1912063777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME95342) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME95342) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2011-10-28 |