| NPI | 1659363562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C142450) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07450100) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2016-12-27 |