| NPI | 1417333253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2018029871) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2020-12-15 |