| NPI | 1245764646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A21022) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 5101025695) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2023-07-31 |