| NPI | 1053709634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 10069932-2501) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MT 4573) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2024-08-29 |