| NPI | 1942620695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 053077) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 269034) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2024-08-02 |