| NPI | 1790195923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 63472) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 63472) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2019-09-13 |