| NPI | 1477681112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2009012869) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AK 53) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2009-06-02 |