| NPI | 1699776971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 223172) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 2023-03449) |
| 208D00000X General Practice (Licence: MA 1017372) | |
| 208D00000X General Practice (Licence: ME DO3907) | |
| 208D00000X General Practice (Licence: TX V0338) | |
| 208D00000X General Practice (Licence: DE C2-0024527) | |
| 208D00000X General Practice (Licence: IA DO-06737) | |
| 208D00000X General Practice (Licence: NH 33171) | |
| 208000000X Pediatrics (Licence: NY 223172) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-09-22 |