| NPI | 1780053835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D80349) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 280499) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2017-02-09 |