| NPI | 1720082076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME114685) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 21877) |
| 208000000X Pediatrics (Licence: VA 0101246540) | |
| 208000000X Pediatrics (Licence: NY 227551) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2023-11-27 |