| NPI | 1285713867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C53008) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WV 18760B) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-09-07 |