| NPI | 1952618399 |
|---|---|
| Former Name | BROOKE ILANA SIEGEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 267-296) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2014-10-31 |