NPI | 1518432046 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP6288) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP6288) |
Enumeration Date | 2018-10-11 |
Last Update Date | 2018-11-16 |