| NPI | 1265450936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: NH 9425) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NH 9425) |
| 208000000X Pediatrics (Licence: VT 0420010669) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2025-11-18 |