| NPI | 1285665943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 180241) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NY 180241) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-01-14 |