| NPI | 1578652939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 221104) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 221104) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2013-03-20 |