| NPI | 1366917403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ PSY-005124) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.009867) |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2019-07-15 |