| NPI | 1053547679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 96074) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IN 99035264A) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: KY 1577) | |
| 208000000X Pediatrics (Licence: GA 96074) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2023-12-20 |