| NPI | 1750540340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: SC 52205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101255344) |
| 208000000X Pediatrics (Licence: TX P0200) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2021-10-05 |