| NPI | 1194748632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD-059788-L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25-MA-06658300) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2016-02-11 |