| NPI | 1124293865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA09233500) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 049971) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2019-07-22 |