| NPI | 1508305467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301016500) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301016500) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2021-11-03 |