| NPI | 1922290402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME108902) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: FL ME108902) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2024-02-15 |