| NPI | 1770367153 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6351004636) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301019645) | 
| Enumeration Date | 2023-08-24 | 
| Last Update Date | 2025-09-22 |