| NPI | 1700063898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA08839500) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 269880) |
| 2080A0000X Pediatrics, Adolescent Medicine (Licence: NJ 25MA08839500) | |
| 208000000X Pediatrics (Licence: MI 4301090490) | |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2021-03-31 |