| NPI | 1730479874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 6262) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CT 003093) |
| 103TC0700X Psychologist, Clinical (Licence: WI 3261-57) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2019-02-11 |