| NPI | 1700414141 |
|---|---|
| Former Name | COLLEEN GENEVIEVE O'NEIL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U9850) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX U9850) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-05-10 |