| NPI | 1982130134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MS 59-1041) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MS 59-1041) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MS 59-1041) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2020-09-28 |