| NPI | 1962728873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA C195669) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD462908) |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2025-05-01 |