| NPI | 1508830282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MA 47939) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: PA MD023656E) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: WV 24123) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-05-18 |