| NPI | 1639325343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: CA G51896) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G51896) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |