| NPI | 1154942258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP6316) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP6316) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2022-09-06 |