| NPI | 1619939998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 64553) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 236719-1) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2021-08-10 |