| NPI | 1497092274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 267834) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA 447050) |
| Enumeration Date | 2013-01-13 |
| Last Update Date | 2014-02-04 |