| NPI | 1679697619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 014148-01) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 014148-01) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2008-09-26 |