| NPI | 1720370158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 279063-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A122395) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2015-10-09 |