| NPI | 1639169709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 159489) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 18720) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2025-01-13 |