| NPI | 1750580700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA08833400) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 60 245792) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2011-06-07 |