| NPI | 1710399696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2404) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: OR 2404) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2016-04-12 |