| NPI | 1174547772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: NY 180786) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: NY 180786) |
| 207Q00000X Family Medicine (Licence: NY 180786) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-08-14 |