| NPI | 1104805639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 158946-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 158946) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2025-10-16 |