| NPI | 1306165113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR 169160) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 275028-1) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2014-09-18 |