| NPI | 1316265564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 54830) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 54830) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2019-11-27 |