| NPI | 1265574784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 210101) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2007-00420) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-10-09 |