| NPI | 1548691173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MO 2020008446) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: KS 04-44347) |
| Enumeration Date | 2013-12-08 |
| Last Update Date | 2025-11-25 |