| NPI | 1780842385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 54431) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 105484) |
| 208000000X Pediatrics (Licence: IA R-8329) | |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2025-04-02 |