| NPI | 1962665141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS LP1895) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 1187) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2022-12-30 |