| NPI | 1386179083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MB10151000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OS018661) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-08-21 |