| NPI | 1942646161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MS 27-131) |
| Additional Taxonomies | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: MS 27131) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2020-09-28 |