| NPI | 1114252616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 267015) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA12034900) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2023-11-17 |