NPI | 1235275868 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 7425) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 7425) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2007-07-08 |