| NPI | 1609820844 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA04462700)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 1487371)  | 
| Enumeration Date | 2006-05-20 | 
| Last Update Date | 2013-07-05 |