| NPI | 1801065677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 049104) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 1842031) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2012-10-11 |