| NPI | 1750836326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007508) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016810) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2024-03-19 |