| NPI | 1225015431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 159632) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 245481) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2008-03-28 |