| NPI | 1740785963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: MD D0091988) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2022-07-07 |