| NPI | 1720057516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A89502) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CA A89502) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2009-02-27 |