| NPI | 1609097773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 68977) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 54144) |
| 208000000X Pediatrics (Licence: PA MD448143) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2026-06-18 |