| NPI | 1164209896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 39926) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: PR 39926) | |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2023-11-07 |