| NPI | 1821128059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 3507) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY 21713) |
| 173000000X Legal Medicine (Licence: WA 26465) | |
| 173000000X Legal Medicine (Licence: UT 7856) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2011-06-16 |