| NPI | 1639306269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 263690) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL 104114) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2020-09-17 |