| NPI | 1265967707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA OS022805) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MB12023000) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2024-09-24 |