| NPI | 1528077120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101257998) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08168200) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-06-28 |