| NPI | 1205110871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 2400) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS T-LMLP 1426) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2013-05-17 |