| NPI | 1962031609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2023013607) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 69650) |
| 208000000X Pediatrics (Licence: MN 30784) | |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2024-01-16 |