| NPI | 1285925255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA 131282) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: N/A) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2022-02-11 |