| NPI | 1720302326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: LA 205395) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 258383) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2012-08-01 |