| NPI | 1427095264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2004010067) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 1114) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2014-12-26 |