| NPI | 1649332578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: MT 9992) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 25561) |
| 2080A0000X Pediatrics Adolescent Medicine (Licence: FL ME50468) | |
| 2080A0000X Pediatrics Adolescent Medicine (Licence: NJ MA45035) | |
| 2080A0000X Pediatrics Adolescent Medicine (Licence: NY 174532-1) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2015-01-15 |