| NPI | 1093118754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN 3506) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MS 54-947) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2020-02-20 |