| NPI | 1710082078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 866) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO R0407) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2007-07-08 |