| NPI | 1780204404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NM PSY-2022-0029) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NM NM-PSY-2022-0029) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2023-04-04 |