| NPI | 1659508117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A119008) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 73353) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2024-04-17 |