| NPI | 1811072267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 201811) |
| Additional Taxonomies | 208D00000X General Practice (Licence: DE C1000) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2011-10-20 |