| NPI | 1740740802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 67874) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 30027) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2023-01-20 |