| NPI | 1881258572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WI 82659) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 72132) |
| Enumeration Date | 2019-04-28 |
| Last Update Date | 2024-04-30 |