| NPI | 1992938534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 70087) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 253959) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2022-11-14 |