| NPI | 1639397193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TX N3088) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: RI LP00324) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2015-08-04 |