| NPI | 1962770719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2502) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 2502) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2023-11-08 |