| NPI | 1104870369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 1999138460) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 1271) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2007-07-09 |