| NPI | 1194979823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04511) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004006) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2017-02-13 |