| NPI | 1902893084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A90199) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 208000000X Pediatrics (Licence: CA A90199) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2022-03-03 |