| NPI | 1689369357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 77510) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 33379) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2024-08-16 |