| NPI | 1235432758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 129364) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: KY 129364) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2019-08-01 |