| NPI | 1558368845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 229898) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 059367) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2021-07-29 |