| NPI | 1972952745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 298075) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT210350) |
| Enumeration Date | 2016-06-12 |
| Last Update Date | 2020-07-03 |