| NPI | 1407225576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 294956) |
| Additional Taxonomies | 282NC2000X General Acute Care Hospital Children (Licence: PR 32,169-R) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2018-08-21 |