| NPI | 1639489255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AZ PSY-004438) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 018797) |
| Enumeration Date | 2010-10-16 |
| Last Update Date | 2019-10-08 |