| NPI | 1558897272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61032678) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A146642) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2025-01-15 |