| NPI | 1356862817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 337063) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 000000000000000) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2023-09-18 |