| NPI | 1710023130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 4018-57) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: MI 6301013973) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2023-05-01 |