| NPI | 1265019244 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 72175) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 31787) | 
| Enumeration Date | 2021-03-25 | 
| Last Update Date | 2022-08-25 |