NPI | 1053837534 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016937) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA 33766) |
Enumeration Date | 2017-08-16 |
Last Update Date | 2023-08-24 |