| NPI | 1720362569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: WA MD61135311) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A118527) |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2023-04-05 |