| NPI | 1073965224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301018395) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301018395) | |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2020-08-04 |