| NPI | 1902314966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 03076) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2021-08-31 |