| NPI | 1346542313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 249987) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 253579) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2013-08-21 |