| NPI | 1164461810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA06395900) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME143314) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-03-24 |