| NPI | 1417061417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY4392) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN1926522) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |