NPI | 1578540175 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP3491) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP3491) |
103TC0700X Psychologist, Clinical (Licence: MN LP3491) | |
Enumeration Date | 2005-12-27 |
Last Update Date | 2007-07-08 |