| NPI | 1861774192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C15467) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA c154647) |
| 208000000X Pediatrics (Licence: LA 300027) | |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2021-11-04 |