| NPI | 1467862045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD464060) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA11545000) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2022-08-23 |