| NPI | 1689839854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 193200000X Multi-Specialty (Licence: CA C532582) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.082670) |
| Enumeration Date | 2008-07-26 |
| Last Update Date | 2023-07-17 |