| NPI | 1164429320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: KY 129055) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: KY 1034) |
| 103TC0700X Psychologist, Clinical (Licence: KY 1034) | |
| Enumeration Date | 2005-07-02 |
| Last Update Date | 2017-09-01 |