| NPI | 1831267418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: CA G27414) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G27414) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2013-03-11 |