| NPI | 1477902252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 298070) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT017204) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2019-07-25 |