| NPI | 1720433667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 325910) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 325910) |
| 208000000X Pediatrics (Licence: DE C1-0023819) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2024-03-13 |