| NPI | 1679066799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TX T9349) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 28259) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2022-11-02 |