| NPI | 1013977651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 200486) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NJ MA65126) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2019-11-13 |