| NPI | 1376540815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 011725) |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: NY 011725) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2022-01-05 |