| NPI | 1598720047 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 158426-1)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 156428)  | 
| 208000000X Pediatrics (Licence: NY 156428-1)  | |
| Enumeration Date | 2006-04-19 | 
| Last Update Date | 2023-02-06 |