| NPI | 1639306467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 9562) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NH 0376) |
| 103TC0700X Psychologist, Clinical (Licence: MA 9562) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2020-11-24 |