| NPI | 1790188720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 022090) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MA 9988) |
| Enumeration Date | 2014-10-05 |
| Last Update Date | 2018-09-18 |