| NPI | 1235516360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 292522) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 79738) |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2025-11-04 |