| NPI | 1730766023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 329253) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 1026727) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2026-07-22 |