| NPI | 1619978293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VT 042.0013055) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 181118) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2018-06-28 |