| NPI | 1174061675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: KY 129107) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KY 129107) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2018-04-30 |