| NPI | 1043212079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 225408) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ID M14796) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2020-04-08 |