| NPI | 1063845170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA12518200) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A126887) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2026-01-22 |