| NPI | 1013302322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 285311) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 285311) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2025-01-23 |