| NPI | 1578289898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP6812) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN LP6812) |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2022-10-18 |