| NPI | 1447645718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 170502) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 294469) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2025-09-11 |