| NPI | 1710966643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 226832-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 042256) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2013-10-15 |