| NPI | 1386068419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G133821) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: AZ 27411) |
| 208000000X Pediatrics (Licence: MN 26949) | |
| 208000000X Pediatrics (Licence: WA 21748) | |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2015-05-05 |