NPI | 1104151471 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IA 1224) |
Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: IA 1224) |
Enumeration Date | 2009-10-05 |
Last Update Date | 2016-02-11 |