| NPI | 1942492970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 245633) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VT 042.0012570) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2013-03-11 |