| NPI | 1063648822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY25149) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2019-01-02 |