| NPI | 1972597649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: WA MD.MD.61418696) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IN 01048702A) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2023-07-20 |