| NPI | 1942732763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 67340) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY R4609) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2020-08-26 |