| NPI | 1629232814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 271342) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT192994) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2021-03-19 |