| NPI | 1457790479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 290230) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT205266) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2019-02-27 |