| NPI | 1295728277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 769) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO PY01440) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2010-01-04 |