| NPI | 1194910372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO 0058877) |
| Additional Taxonomies | 282NC2000X General Acute Care Hospital Children (Licence: MS T-1991) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2018-03-17 |