| NPI | 1174962971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 307215) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 81637) |
| 208000000X Pediatrics (Licence: GA 81637) | |
| 208000000X Pediatrics (Licence: NY 307215) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2020-10-21 |