| NPI | 1386855823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME93245) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 171237) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2016-04-19 |