| NPI | 1780797621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301012527) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301012527) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2019-06-06 |