| NPI | 1487069431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 144894) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 144894) |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2014-06-29 |