| NPI | 1730758590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MO 2024030392) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2024030392) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2024-10-01 |