| NPI | 1396716502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101242213) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 217097) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2011-01-07 |