| NPI | 1487984886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD046778L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA06264400) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2010-01-06 |