| NPI | 1720126907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA PSY22990) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA RPS2006034) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2017-05-01 |