| NPI | 1770534760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: MA 215140) |
| Additional Taxonomies | 2083A0300X Preventive Medicine Addiction Medicine (Licence: MA 215140) |
| Enumeration Date | 2006-05-14 |
| Last Update Date | 2022-11-17 |