| NPI | 1760502132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 220180) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 220180) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2017-08-22 |