| NPI | 1902056989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A99300) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A99300) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2017-01-20 |