| NPI | 1538497599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 69608) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 218029) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2024-05-27 |