| NPI | 1992777502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 200132-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD055134L) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2011-09-15 |