| NPI | 1659491090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: ND 11205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ND PT11205) |
| 208000000X Pediatrics (Licence: MN 49784) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2022-03-25 |