NPI | 1659363562 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA C142450) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07450100) |
Enumeration Date | 2005-08-17 |
Last Update Date | 2016-12-27 |