| NPI | 1962113878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 33964) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301019212) |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2023-01-20 |