| NPI | 1063508372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 8253) |
| Additional Taxonomies | 261QV0200X Clinic/Center, VA (Licence: MA 8253) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2017-04-13 |