NPI | 1003934456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NJ 35SI00370200) |
Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS005068L) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2007-07-08 |