| NPI | 1063636512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 41634) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AZ 41634) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 233363) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2021-12-02 |