| NPI | 1407296908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 290723) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VT 042.0013867) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2022-07-21 |