| NPI | 1245360452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 016471) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CT 002747) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2011-03-14 |