| NPI | 1699883496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 4804096-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07517600) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2021-11-03 |