| NPI | 1811300387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A15458) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT016058) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2017-06-21 |