| NPI | 1124741558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6352000741) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6352000741) |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-09-21 |