| NPI | 1497214639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 73770) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 315234) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2023-05-29 |