| NPI | 1336816321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6362001476) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MI 6362001476) |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2022-08-05 |