| NPI | 1184033482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA09583100) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD450110) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2016-01-31 |