| NPI | 1154612349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NC 4578) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810004448) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2014-10-30 |