| NPI | 1194910257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 63733) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 258555) |
| 208000000X Pediatrics (Licence: WI 20899) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2021-06-22 |