| NPI | 1578881264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 263060) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A112212) |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2021-03-01 |