| NPI | 1134625924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: OH 35141895) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.072651) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2021-07-20 |