| NPI | 1780761015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 163339) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 188723) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-01-16 |