| NPI | 1619243060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 316825) |
| Additional Taxonomies | 2080H0002X (Licence: MD D79092) |
| 2080H0002X (Licence: NY 316825) | |
| 2080H0002X (Licence: TX S4354) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2022-07-25 |