| NPI | 1043704679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TE1100X Psychologist, Exercise & Sports |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP6042) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-01-14 |