| NPI | 1417563180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: VA 0810007243) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2023-08-08 |