| NPI | 1811370729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN 6199) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 2617) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2020-12-21 |