| NPI | 1770618605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A72590) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A72590) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2023-01-03 |