| NPI | 1184927626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry (Licence: LA 1390) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810004424) |
| 103TC0700X Psychologist Clinical (Licence: MA 9280) | |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2017-04-25 |