| NPI | 1790393114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 69901) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 30837) |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2021-08-26 |