| NPI | 1194710863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 1757) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PSY.0001757) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2024-03-11 |