| NPI | 1922397629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 52555) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A11664) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2016-06-09 |