| NPI | 1700625662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP7049) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP7049) |
| Enumeration Date | 2024-05-21 |
| Last Update Date | 2025-04-21 |