| NPI | 1710115852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 260041) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 260041) |
| Enumeration Date | 2009-06-27 |
| Last Update Date | 2022-10-24 |