| NPI | 1013342211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3662) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP5846) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2019-10-14 |