| NPI | 1104949619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA psy 8348) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: CA psy8348) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2009-01-23 |