| NPI | 1457608812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: NJ 25MB12006300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MB12006300) |
| 208000000X Pediatrics (Licence: NY 278225) | |
| Enumeration Date | 2012-08-04 |
| Last Update Date | 2024-05-16 |