| NPI | 1467831099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KY 52642) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME135110) |
| 208000000X Pediatrics (Licence: KY 52642) | |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2022-08-16 |