| NPI | 1447553565 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 155960-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ MA 040434) |
| Enumeration Date | 2010-12-11 |
| Last Update Date | 2012-12-19 |