| NPI | 1104091404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC PSY1066) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: SC PSY1066) |
| 103TC0700X Psychologist, Clinical (Licence: GA PSY003031) | |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2008-04-28 |