| NPI | 1851568505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI MT88-228) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 36627) |
| 208000000X Pediatrics (Licence: WI 36627-20) | |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2011-12-23 |