| NPI | 1639199094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 297113) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 224860) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-01-09 |