| NPI | 1104662691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP7069) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MN LP7069) |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-09-05 |