| NPI | 1851703284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MT206705) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA10389400) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2018-08-02 |