| NPI | 1245567429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL 8005) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9197701) |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2020-06-04 |