| NPI | 1619586815 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY10829) | 
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CT 003969) | 
| 103T00000X Psychologist (Licence: CT 003969) | |
| Enumeration Date | 2020-07-24 | 
| Last Update Date | 2023-08-25 |