| 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 |