| NPI | 1760123723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1026924) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1026924) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-05-28 |