| NPI | 1609132059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NC 2018-01232) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2018-01232) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2023-12-21 |