| NPI | 1508200064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 001251) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: IA 001251) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2013-04-26 |