NPI | 1366776262 |
---|---|
Former Name | LILLIAN ALICIA FLORES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004751) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2009-09-24 |
Last Update Date | 2015-04-20 |