| NPI | 1326042169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 1810) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 02183) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2007-07-08 |