| NPI | 1700989308 | 
|---|---|
| Former Name | MINNETTE BLACK | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA G48910)  | 
| Enumeration Date | 2006-09-07 | 
| Last Update Date | 2023-03-07 |