| NPI | 1386063907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A159227) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 290447) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2023-03-22 |