| NPI | 1326004078 |
|---|---|
| Professional Name | N/A N/A |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A76745) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A76745) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-12-28 |