| NPI | 1114466323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CO NLC.0107232) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO NLC.0107232) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2018-03-17 |