NPI | 1194716860 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MA 75965) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 75965) |
Enumeration Date | 2005-11-02 |
Last Update Date | 2014-07-03 |