| NPI | 1114022076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G63849) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G63849) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2017-01-17 |