| NPI | 1710972138 |
|---|---|
| Former Name | MIRIAM ALEXANDRA GOWON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G63060) |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: CA G63060) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2013-03-31 |