| NPI | 1396120507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2015000880) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 2365) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2016-12-12 |