| NPI | 1912505967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 023915) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 023915) |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2022-01-21 |