NPI | 1689290991 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MT PSY-PSY-LIC-4936) |
Additional Taxonomies | 103T00000X Psychologist (Licence: IA 095471) |
Enumeration Date | 2020-06-23 |
Last Update Date | 2024-04-09 |