| NPI | 1043404064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60217255) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ID PSY203058) |
| Enumeration Date | 2007-09-03 |
| Last Update Date | 2025-09-04 |