| NPI | 1972865509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: NC 2022-00428) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 34812) |
| 208000000X Pediatrics (Licence: SC LL 34812) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2025-10-15 |