| NPI | 1508512716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ID 4961369) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS 03113) |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2024-10-08 |