| NPI | 1497428098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810008302) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2025-07-03 |