| NPI | 1811050248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 0120) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP1082) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-08 |