| NPI | 1497981088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TX P3563) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P3563) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2021-09-10 |