| NPI | 1619230042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A134493) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 56589) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2020-06-01 |