NPI | 1134156037 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY14709) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 1147289) |
Enumeration Date | 2006-06-27 |
Last Update Date | 2018-04-09 |