| NPI | 1457717274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 04722) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810004238) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2017-03-28 |