| NPI | 1073137071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301018888) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 6352000204) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2021-07-23 |