| NPI | 1205972791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: WA MD00020632) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |