NPI | 1245525807 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IL 036143938) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD 60478044) |
2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: WA 60478044) | |
Enumeration Date | 2011-06-12 |
Last Update Date | 2018-06-27 |