| NPI | 1699168864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS17088) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 292302) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2020-08-18 |