NPI | 1629364104 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA 20A17241) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT014077) |
Enumeration Date | 2011-06-23 |
Last Update Date | 2020-06-03 |