| NPI | 1235221649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: OH 35.093852) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TN MDO000I05 I 81) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2009-07-02 |