| NPI | 1386866176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CA G72702) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: CA 550000003) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |