| NPI | 1528298742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA08875400) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 60251657) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2016-11-22 |