| NPI | 1114977592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY10060) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY10060) |
| 103TR0400X Psychologist, Rehabilitation (Licence: MI 6301012509) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2018-03-17 |