NPI | 1770141319 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000636) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 283207) |
103TC0700X Psychologist, Clinical (Licence: IL 071010042) | |
Enumeration Date | 2019-05-29 |
Last Update Date | 2024-11-13 |