| NPI | 1104923374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P2919) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME96333) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 250317) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-04-12 |