| NPI | 1114390598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2017010148) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IA 073513) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2017-05-10 |