| NPI | 1124702188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-06-12 |