| 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 |