| NPI | 1427225788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101265045) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 262731) |
| 261QP2300X Clinic/Center, Primary Care (Licence: NY 262731) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2022-07-21 |