| NPI | 1104133081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05742) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021387) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2023-12-05 |