| NPI | 1962588806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD462149) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 222251) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2019-12-18 |