| NPI | 1558410142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS 121) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS 0549) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2022-09-18 |