| NPI | 1861447914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: SC 1821) |
| Additional Taxonomies | 103TE1100X Psychologist Exercise & Sports (Licence: OH 5724) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2024-01-19 |