| NPI | 1912907692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NY 225968) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 225968-1) |
| 208D00000X General Practice (Licence: NY 225968) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2025-04-29 |