| NPI | 1508822164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MO 2004012756) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KS 04-31334) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2026-01-09 |