| NPI | 1235596107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A14636) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL UO3516) |
| Enumeration Date | 2016-01-24 |
| Last Update Date | 2016-12-13 |