| NPI | 1619979200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VT 042.0018206) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ MA72550) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2025-07-14 |