| NPI | 1639815731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 75338) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 32747) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2023-09-21 |