| NPI | 1669478582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2022033678) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 58031) |
| 208000000X Pediatrics (Licence: SD 8116) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2022-09-29 |