| NPI | 1265920839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX V6974) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 309869) |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2025-08-26 |