| NPI | 1568966984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 335225) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 287047) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-07-07 |