| NPI | 1912081266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME78157) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME 78157) |
| 208000000X Pediatrics (Licence: FL ME78157) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2013-01-04 |