| NPI | 1174807804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY29513) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: None) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2022-10-20 |