| NPI | 1104159334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NV 8117) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G069741) |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2009-09-04 |