| NPI | 1861525420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS 0669) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 250) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |