| NPI | 1043233596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA09301700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD-043998-E) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2014-05-28 |