| NPI | 1093743619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: WA MD60459088) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G72907) |
| 208000000X Pediatrics (Licence: WA MD60459088) | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA G072907) | |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: WA MD60459088) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2015-11-13 |