| NPI | 1023500113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 6325) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WI 3557-57) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-11-12 |