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 |