| NPI | 1063453645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 1635) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2006007250) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2016-02-05 |