| NPI | 1639306467 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP7042)  | 
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NH 0376)  | 
| 103G00000X Clinical Neuropsychologist (Licence: MA 9562)  | |
| 103TC0700X Psychologist, Clinical (Licence: MA 9562)  | |
| Enumeration Date | 2009-06-19 | 
| Last Update Date | 2024-08-12 |