| NPI | 1891999462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 20A 10956) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP1-0023120) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2013-03-13 |