| NPI | 1770799215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 296263) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 004957-1) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2018-11-14 |