| NPI | 1720143662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C50077) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 148027) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-05-06 |