| NPI | 1053454520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 202465) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07663400) |
| 208000000X Pediatrics (Licence: MA 219571) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2022-07-15 |