| NPI | 1265744783 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA A125350) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A125350) | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A125350) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 61005) | |
| Enumeration Date | 2010-07-13 | 
| Last Update Date | 2025-06-30 |