| NPI | 1700453057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: TX V0431) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 12912) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-07-22 |