| NPI | 1750766960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: PR 19703) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PR 19703) |
| 208000000X Pediatrics (Licence: MA 279581) | |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2025-02-07 |