| NPI | 1194809111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60095203) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 050019) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: WA MD60095203) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2023-10-18 |