| NPI | 1962614149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301110875) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 253383-1) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2016-09-01 |