NPI | 1962965541 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NY 318725) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 318725) |
Enumeration Date | 2019-04-10 |
Last Update Date | 2025-04-10 |