| NPI | 1023173804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 01834) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NM 390) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2013-04-03 |