| NPI | 1235653452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 75936) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2020-00654) |
| Enumeration Date | 2017-07-29 |
| Last Update Date | 2024-02-15 |