| NPI | 1750644613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 40200) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 29993) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2025-07-30 |