NPI | 1275820821 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP6447) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MA 09374) |
Enumeration Date | 2011-07-05 |
Last Update Date | 2019-10-01 |