| NPI | 1396264941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 33247) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 33247) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2024-04-30 |