| NPI | 1790143642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD C06716) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00389600) |
| Enumeration Date | 2016-02-07 |
| Last Update Date | 2018-05-02 |