| NPI | 1124113691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MB06729500) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 179827) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-07-19 |