| NPI | 1124346804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL OS13730) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MB09261900) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2016-09-09 |