| NPI | 1619912987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 235958) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MB77416) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2015-10-02 |