| NPI | 1578955852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD61545764) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A163472) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2024-10-21 |