| 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 |