| NPI | 1619903069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA0059561) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA59561) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2019-11-12 |