| NPI | 1073046637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 331318) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 0000) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2024-07-15 |