| NPI | 1194213355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MO 2017041333) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2023-11-01 |