| NPI | 1174055420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 80604) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MB10875600) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2025-06-04 |