| NPI | 1063665032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 7471332-1205) |
| Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: UT 7471332-1205) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2022-10-18 |