| NPI | 1609012442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: WA MD60135081) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60135081) |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2022-11-15 |