| NPI | 1568728475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 84470) |
| Additional Taxonomies | 2080H0002X (Licence: GA 84470) |
| 2080H0002X (Licence: FL ME133353) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 84470) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 84470) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2023-10-24 |