| NPI | 1720158934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: VT 0420012903) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 231907) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2014-06-05 |