| NPI | 1669178190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06927) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY11744) |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2024-03-26 |