| NPI | 1518378694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 67606) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 75661) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2021-09-01 |