| NPI | 1255736476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA A149935) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A149935) |
| 282N00000X General Acute Care Hospital | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2020-10-27 |