| NPI | 1417274648 |
|---|---|
| Former Name | JACQUELINE COOPERMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology (Licence: NY 269536) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 269536) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2019-01-16 |