| NPI | 1962694562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME 99471) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME 99471) |
| 208D00000X General Practice (Licence: TX U3919) | |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2023-05-02 |