| NPI | 1740297076 |
|---|---|
| Former Name | AVIAN WEST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX R7343) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA08575900) |
| 208M00000X Hospitalist (Licence: NJ 25MA08575900) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-03-18 |