| NPI | 1902060858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 252790) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD442319) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2012-12-27 |