| NPI | 1316289929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A170055) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA09922100) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2021-06-26 |