| NPI | 1487088894 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: SC 1275)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 1275)  | 
| Enumeration Date | 2013-08-22 | 
| Last Update Date | 2016-06-15 |