| NPI | 1285000315 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: VA 0810005613) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005613) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-12 | 
| Last Update Date | 2023-08-11 |