| NPI | 1215932074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IA 38049) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 45397) |
| 208000000X Pediatrics (Licence: NJ 25MA04720100) | |
| 208000000X Pediatrics (Licence: MA 226658) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2008-11-07 |