NPI | 1164796850 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: WA OP60861286) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA OS017575) |
Enumeration Date | 2012-02-28 |
Last Update Date | 2021-04-08 |