| NPI | 1205023546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 106163) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ MA023641) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2007-10-01 |