| NPI | 1770555013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A37377) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A37377) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2023-04-19 |