| NPI | 1912968322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 260383) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 219815) |
| 208000000X Pediatrics (Licence: MA 219815) | |
| 208000000X Pediatrics (Licence: NY 260383) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2014-03-19 |