| NPI | 1740539931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 267198) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 051255) |
| Enumeration Date | 2012-09-03 |
| Last Update Date | 2013-10-21 |