| NPI | 1528677085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME154297) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07432300) |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2022-08-16 |