| NPI | 1982965604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 294606) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT201798) |
| 208000000X Pediatrics (Licence: PA MD454014) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2018-07-02 |