| NPI | 1073760930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA08622700) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125-05-08-00) |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2013-05-24 |