| NPI | 1821357039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 279908) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 054211) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2018-07-27 |