| NPI | 1982884367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012848) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704167066) |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2012-11-19 |