| NPI | 1932236924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2019-057) |
| Additional Taxonomies | 103T00000X Psychologist |
| 163W00000X Registered Nurse | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-07-08 |