| NPI | 1962999862 |
|---|---|
| Former Name | AUTUMN TANI-WINEGARDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 66038) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 29302) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2022-11-10 |