| NPI | 1467652602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A98076) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A98076) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2011-10-03 |