| NPI | 1619750650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 77796) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 33344) |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2024-08-05 |