| NPI | 1790983120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 1173) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS LMLP 1173) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2021-06-22 |