| NPI | 1295350858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 73677) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL83207) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2023-06-15 |