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 |