| NPI | 1184909442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 115619) |
| Additional Taxonomies | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: TX E2265) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |