| NPI | 1518303171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 285171) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 1020097) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2025-03-12 |