| NPI | 1497701197 |
|---|---|
| Other Name | MIMI PANTUHOVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 6733) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MA 6733) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2009-12-08 |