| NPI | 1558326330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 281964) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 054577) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2015-10-21 |