NPI | 1629717244 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MN 79821) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NE 9281) |
Enumeration Date | 2022-06-01 |
Last Update Date | 2025-07-18 |