| NPI | 1730551573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 30397) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA PSB94021974) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2018-10-10 |