| NPI | 1740910645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 80091) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-12600) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2025-08-07 |