| NPI | 1710215215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 254837) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 49318) |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2025-01-24 |