| NPI | 1235477787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 287173) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2021-06-15 |