| NPI | 1912647991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 74790) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 32482) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2023-07-17 |