| NPI | 1902102999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 258526) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 049262) |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2011-05-02 |