| NPI | 1992992887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME102030) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MA 258857) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA 151456) | |
| 208D00000X General Practice (Licence: TX BP10021650) | |
| 208D00000X General Practice (Licence: FL ME102030) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2017-10-20 |