| NPI | 1962526343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 257801) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 257801) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2023-07-17 |