| NPI | 1912177031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016836) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY21698) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2011-12-25 |