| NPI | 1235369968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A125863) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT195556) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2021-12-17 |