| NPI | 1093700619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 036575) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 210743) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2016-02-29 |