| NPI | 1972823052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N5142) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08619800) |
| 208000000X Pediatrics (Licence: NY 254006-1) | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2022-01-10 |