| NPI | 1992194906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ 25MA10374000) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 296016-1) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2021-10-19 |