| NPI | 1730191024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NH 12922) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 222648) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2011-10-12 |