| NPI | 1346580552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TN 274494466) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 274494466) |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2013-02-27 |