| NPI | 1205876158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TA0700X Psychologist Adult Development & Aging (Licence: KS 0376) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS 037) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |