| NPI | 1649774191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 76169) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301505375) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-04-25 |