| NPI | 1114361995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA 30977) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 30895) |
| 103TR0400X Psychologist Rehabilitation (Licence: TX 30895) | |
| 103TR0400X Psychologist Rehabilitation (Licence: CA 30977) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2019-12-05 |