| NPI | 1124260393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 252404) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL OS12259) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2013-08-19 |