| NPI | 1851307029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MI 4301064194) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301064194) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2013-10-14 |