| NPI | 1205397981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 67853) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 30053) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2020-08-26 |