| NPI | 1134171655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: SC 877) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 877) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-05-25 |