| NPI | 1265795934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301015679) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301015103) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2013-08-28 |