| NPI | 1396762472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 034893) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 201664) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2019-04-02 |