| NPI | 1679550172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP4036) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP4036) |
| 103TC0700X Psychologist Clinical (Licence: MN LP4036) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2007-07-08 |