| NPI | 1942595038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 251243) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 260235) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2023-11-09 |