| NPI | 1407387723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 72494) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME DO3235) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-10-27 |