| NPI | 1063410041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 182271) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 180271) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2023-09-12 |