| NPI | 1124083688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 3338) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 3338) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2019-01-23 |