| NPI | 1104310325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 317205-01) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.073180) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2025-01-16 |