NPI | 1316203391 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: MO 2015020994) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KS 9408758) |
Enumeration Date | 2012-04-04 |
Last Update Date | 2018-08-31 |