| NPI | 1700614054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 80418) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 34410) |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2025-08-30 |