| NPI | 1114232030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 001118) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071.007883) |
| 103TH0100X Psychologist Health Service (Licence: IA 000541) | |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2017-04-25 |