| NPI | 1053621623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY8162) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY8162) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2019-01-03 |