| NPI | 1972597938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 41894) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MN 41894) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2011-12-01 |