| NPI | 1124258306 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: TX V4060) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 6136) | 
| Enumeration Date | 2009-07-21 | 
| Last Update Date | 2024-11-21 |