NPI | 1053665034 |
---|---|
Former Name | MARIE DIANA SCHRODER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1613) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: AL 1613) |
Enumeration Date | 2012-10-30 |
Last Update Date | 2012-10-30 |