| NPI | 1902105786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 019033) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 019033) |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2011-08-23 |