| NPI | 1841615200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 286223) |
| Additional Taxonomies | 282NR1301X General Acute Care Hospital, Rural |
| Enumeration Date | 2014-02-21 |
| Last Update Date | 2020-11-24 |