NPI | 1588692065 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MO 2003030080) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2003030080) |
Enumeration Date | 2006-06-30 |
Last Update Date | 2007-10-19 |