| NPI | 1528365251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2012038439) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS LP 1649) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2013-01-08 |