| NPI | 1104189463 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35.130830)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT201996)  | 
| Enumeration Date | 2012-06-21 | 
| Last Update Date | 2018-07-12 |