| NPI | 1013931617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 056388) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: GA 56388) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2016-09-23 |