| NPI | 1275017147 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006053) | 
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: VA 0810006053) | 
| Enumeration Date | 2018-09-18 | 
| Last Update Date | 2023-08-11 |