| NPI | 1306850557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MI 4301070302) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301070302) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2012-03-01 |