| NPI | 1629053327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 107307) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR DO24785) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2021-01-14 |