| NPI | 1255617809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 62087-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 72539) |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2022-10-05 |