| NPI | 1649858564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 71903) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 31584) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2022-08-25 |