| NPI | 1821135534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: NH 4245) |
| Additional Taxonomies | 2080A0000X Pediatrics Adolescent Medicine (Licence: NY 099913) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2025-08-31 |