| NPI | 1023055712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MD 33751) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 33751) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2015-09-02 |