| NPI | 1366657884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 26809) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301093549) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-01-27 |