| NPI | 1972646966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI DPI #61) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 350000108827) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |