NPI | 1114967759 |
---|---|
Former Name | KATHLEEN M OTOOLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: GA 001931) |
Additional Taxonomies | 103T00000X Psychologist (Licence: GA 001931) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2007-07-08 |