| NPI | 1275819922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 54469) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08798500) |
| 208000000X Pediatrics (Licence: NY 268149) | |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2015-08-03 |