| NPI | 1033131420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD-042214-L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25-MA-05432500) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2012-03-27 |