| NPI | 1619907771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MS 43-703) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 43703) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MS 43703) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-09-28 |