| NPI | 1720668973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1022890) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 330522) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2025-11-15 |