| NPI | 1548603509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 63568) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 268017) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2020-09-18 |