| NPI | 1922198274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 42924) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME104911) |
| 208000000X Pediatrics (Licence: SD LT1185) | |
| 208000000X Pediatrics (Licence: ME TD09110) | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2013-07-25 |