| NPI | 1922045640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME94231) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 50962) |
| 208000000X Pediatrics (Licence: PA MD421682) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2019-12-04 |