| NPI | 1568879807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05862) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MD 05862) |
| 103TR0400X Psychologist, Rehabilitation (Licence: MD 05862) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2019-06-10 |