| NPI | 1063702587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND 16575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 59724) |
| 207R00000X Internal Medicine (Licence: ND 16575) | |
| 208000000X Pediatrics (Licence: MN 59724) | |
| 208000000X Pediatrics (Licence: ME MD23572) | |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2021-08-24 |