| NPI | 1215979422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 153750) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 172661) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-05-14 |