| NPI | 1003176926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA11634200) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 283655) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2025-10-20 |