| NPI | 1982004164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA 141967) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA 08157554) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2016-07-19 |