| NPI | 1073024469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MI C512048585587) |
| Additional Taxonomies | 372600000X Adult Companion |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2017-10-12 |