| NPI | 1780114207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: VA 0810007265) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810007265) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2022-01-27 |