| NPI | 1598798738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: CA A42230) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA a42230) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2023-01-03 |