| NPI | 1417576026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MN 70015) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: WI 83377) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2024-04-23 |