| NPI | 1457747263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 302513) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD H85422) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2021-11-17 |