| NPI | 1902122104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4012) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN 4012) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2014-03-27 |