| NPI | 1164048013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 74536) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP05095) |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2023-09-07 |