| NPI | 1679583405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: NH 16160) |
| Additional Taxonomies | 2080A0000X Pediatrics Adolescent Medicine (Licence: CT 38302) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2018-02-12 |