| NPI | 1619900651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 3968) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ mb52205) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2022-07-21 |