| NPI | 1124032750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: DE C1-0006480) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25-MA-07452300) |
| 208000000X Pediatrics (Licence: PA MD-423599) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2011-01-10 |