| NPI | 1558881870 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 1020263)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 69954)  | 
| 208000000X Pediatrics (Licence: IA MD-47572)  | |
| 208000000X Pediatrics (Licence: MO 2017016024)  | |
| Enumeration Date | 2017-06-27 | 
| Last Update Date | 2025-03-06 |