| NPI | 1568662492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 046513) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 244100) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2021-04-30 |