| NPI | 1902301849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 74027) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 21437) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2026-02-18 |