| NPI | 1679099204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6352000656) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2022-07-21 |