| NPI | 1700481785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10768) |
| Additional Taxonomies | 103TE1100X Psychologist Exercise & Sports (Licence: FL PY10768) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2024-05-09 |