| NPI | 1104826189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G67254) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G67254) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2021-11-08 |