| NPI | 1487828216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 556) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO AC38192365029) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2022-01-17 |