| NPI | 1104529064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TN 8107) |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: TN 8107) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2024-01-09 |