| NPI | 1700861440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 190123-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 038571) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2013-10-16 |