| NPI | 1265420244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA a98623) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00040212) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2022-01-26 |