| NPI | 1912534900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 69657) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 30783) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2021-08-17 |