| NPI | 1033372891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080C0008X Pediatrics Child Abuse Pediatrics (Licence: RI MD14548) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD442550) |
| 208000000X Pediatrics (Licence: PA MT193447) | |
| 282NC0060X General Acute Care Hospital Critical Access (Licence: PA MD442550) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2016-03-11 |