| NPI | 1487636940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: CA G45968) |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: MT 10233) |
| 208000000X Pediatrics (Licence: MT 10233) | |
| 208000000X Pediatrics (Licence: ND 8215) | |
| 208000000X Pediatrics (Licence: CA G45968) | |
| 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: ND 8215) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2015-05-02 |