| NPI | 1396250791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 71778) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 15256) |
| 208000000X Pediatrics (Licence: PR 15256I) | |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2023-06-02 |