| NPI | 1578645586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA 60205336) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 116111) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2013-04-24 |