| NPI | 1467513580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP3914) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MN LP3914) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2007-11-26 |