| NPI | 1518904218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301009459) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301009459) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301009459) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2012-05-02 |