| NPI | 1568912525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 10457) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MA 10457) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |