| NPI | 1538664909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 312124) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA11229200) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2022-01-19 |