| NPI | 1801272505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 294535) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME136782) |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2026-01-05 |