| NPI | 1760410492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 230228) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 232450) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2021-02-18 |