| NPI | 1134291115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 21053) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 016374) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2017-05-11 |