| NPI | 1194910257 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 63733) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 20899) | 
| 208000000X Pediatrics (Licence: NY 258555) | |
| Enumeration Date | 2007-09-12 | 
| Last Update Date | 2024-12-16 |