| NPI | 1417306747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MB10536800) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT017152) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2019-08-30 |