| NPI | 1104130483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 260292) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 260292) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2014-07-08 |