| NPI | 1760755540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: CA A119940) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A 119940) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2024-04-08 |