| NPI | 1306343207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 66494) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 29162) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2021-10-25 |