| NPI | 1417159161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C55464) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2007018726) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2015-03-18 |