| NPI | 1134385842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NJ 25MA09966900) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 247980) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NY 247980) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2024-08-16 |