| NPI | 1679579593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2018040218) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MO 01878) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2019-08-16 |