| NPI | 1811194434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 153234-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA04402300) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2022-11-01 |