| NPI | 1710964705 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 43875)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 43875)  | 
| Enumeration Date | 2005-12-29 | 
| Last Update Date | 2016-03-08 |