| NPI | 1063647469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2012019675) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A107837) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2012-11-02 |