| NPI | 1407893456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KS 04-40273) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2003012943) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2019-06-13 |