| NPI | 1952530560 |
|---|---|
| Former Name | HEATHER ANNE TYRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: NJ 25MB09954500) |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: OH 010917) |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2022-01-19 |