| NPI | 1336275403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: NY 295923) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200000753) |
| 208000000X Pediatrics (Licence: NY 295923) | |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2019-10-21 |