| NPI | 1578804084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CA G7129) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G7129) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-03-07 |