| NPI | 1083145346 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 287791)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 304261)  | 
| Enumeration Date | 2017-03-27 | 
| Last Update Date | 2022-05-11 |