| NPI | 1780899773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A110434) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 224983) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-02-11 |