| NPI | 1609535806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 2665832) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 2665832) |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2021-12-15 |