| NPI | 1730743428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 68252) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 29999) |
| Enumeration Date | 2019-04-28 |
| Last Update Date | 2023-01-26 |