| NPI | 1063788255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A15739) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL OS13454) |
| Enumeration Date | 2012-04-01 |
| Last Update Date | 2017-11-15 |