| NPI | 1760539621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 55315) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 44912) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2021-03-12 |