| NPI | 1801169248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA OS004602L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MB04452600) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |