| NPI | 1114349164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NJ 25MA10031600) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 272884) |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2018-03-17 |