| NPI | 1568689099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 213623) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 213623) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2011-12-06 |