| NPI | 1265431696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MI 4301061288) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: MI 4301061288) |
| 208000000X Pediatrics (Licence: MI 4301061288) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2025-11-03 |