| NPI | 1710143789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: VA 0810000348) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810000348) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2019-08-12 |