| NPI | 1649409665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 61350) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60280219) |
| Enumeration Date | 2009-07-12 |
| Last Update Date | 2024-04-12 |