NPI | 1487654372 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 009101-1) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 009101-1) |
Enumeration Date | 2005-07-21 |
Last Update Date | 2007-07-08 |