NPI | 1316235161 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MO 2014031963) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301015280) |
103T00000X Psychologist (Licence: MI 6301014842) | |
Enumeration Date | 2011-07-14 |
Last Update Date | 2023-03-14 |