| NPI | 1023135290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 47168) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 49846) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2025-01-27 |