| NPI | 1710917372 |
|---|---|
| Former Name | SHELLY D. HOLSTRUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: SC 23497) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-01-31 |