| NPI | 1205213261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: IL 036.156277) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: DE C7-0005910) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2021-05-12 |