| NPI | 1629274865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: NJ 25MA08467500) |
| Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: PA MD435198) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2014-08-23 |