| NPI | 1730410762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 263880) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 263880) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2012-08-28 |