| NPI | 1811791221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 83370) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 35178) |
| Enumeration Date | 2025-04-03 |
| Last Update Date | 2026-07-30 |