| NPI | 1043384613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 206641-1) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NY 206641-1) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2012-03-01 |