| NPI | 1366701765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 262396) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MA 262396) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2021-08-06 |