NPI | 1982815171 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME138422) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01082384A) |
208D00000X General Practice (Licence: VA 0101241220) | |
Enumeration Date | 2007-05-27 |
Last Update Date | 2021-05-12 |