| NPI | 1053831651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: OH 35.148627) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.148627) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2024-02-16 |