| NPI | 1619108453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD472097) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 307246) |
| 208000000X Pediatrics (Licence: NH 20779) | |
| 208000000X Pediatrics (Licence: MI 4301502310) | |
| 208000000X Pediatrics (Licence: NJ 25MA10408900) | |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2020-12-03 |