| NPI | 1104276229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 279591) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 274346-443) |
| 208000000X Pediatrics (Licence: CA 20A18111) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2023-10-27 |