| NPI | 1861591018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL 121256) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 204443) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-10-28 |