| NPI | 1609249721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4675) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: AZ 4675) |
| Enumeration Date | 2015-11-11 |
| Last Update Date | 2015-11-11 |