| NPI | 1972700318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 244943) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 239881) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2019-06-19 |