| NPI | 1962996710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 71082) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 8302) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2022-08-19 |