| NPI | 1770727992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 106301) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 106301) |
| Enumeration Date | 2009-05-01 |
| Last Update Date | 2009-05-01 |