| NPI | 1780949735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: TX R5998) |
| Additional Taxonomies | 282NC2000X General Acute Care Hospital Children (Licence: MA 252625) |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2018-07-03 |