| NPI | 1962494732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD068933L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME129688) |
| 208000000X Pediatrics (Licence: NY 215035) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2023-03-07 |