| NPI | 1144843681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MA 1020123) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04982) |
| 208000000X Pediatrics (Licence: RI LP04982) | |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2024-08-01 |