| NPI | 1588058846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 73804) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 292654) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2023-05-01 |