| NPI | 1992365068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY32246) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY32246) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2021-01-06 |