| NPI | 1629166012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 049276) |
| Additional Taxonomies | 282NC2000X General Acute Care Hospital, Children (Licence: GA 049276) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2022-09-19 |