| NPI | 1417910076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: AZ 56115) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 200927) |
| 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: NY 200927) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2023-09-26 |