| NPI | 1245574987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 05290) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004655) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2018-07-26 |