| NPI | 1720040322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A 10417) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 222257) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2009-01-20 |