| NPI | 1891181525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 304512) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA10359800) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2022-03-16 |