| NPI | 1770638041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 225782) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 225782-1) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2022-07-14 |