| NPI | 1497762629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NM MD2023-1277) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ MA69683) |
| 208000000X Pediatrics (Licence: PA MD058635L) | |
| 208000000X Pediatrics (Licence: TX L8604) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-12-08 |