| NPI | 1679546808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA Psy20999) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301012879) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-02-11 |