| NPI | 1588953467 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MA 258573) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 258573) | 
| 208000000X Pediatrics (Licence: CA A124913) | |
| Enumeration Date | 2011-03-31 | 
| Last Update Date | 2019-05-03 |