| NPI | 1801914742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 224534) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NJ 25ma07959400) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2011-07-12 |