| NPI | 1861130106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 335113) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT225236) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2025-06-09 |