| NPI | 1619066446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 4444) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MN 4444) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2009-03-09 |