| NPI | 1558649145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 272474) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 290231) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2022-09-05 |