NPI | 1255331237 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY0004903) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY4903) |
Enumeration Date | 2005-07-30 |
Last Update Date | 2008-06-19 |