| NPI | 1659516557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: OR MD155302) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD155302) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2019-08-19 |