NPI | 1184801573 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301084572) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA A107664) |
Enumeration Date | 2008-01-28 |
Last Update Date | 2021-10-14 |