| NPI | 1770372708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS 2305) |
| Additional Taxonomies | 103TH0004X Psychologist Health (Licence: KS 2305) |
| 103TH0100X Psychologist Health Service (Licence: KS 2305) | |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-05-05 |