| NPI | 1598150419 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 70011) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 61854) | 
| Enumeration Date | 2015-03-30 | 
| Last Update Date | 2024-03-29 |