| NPI | 1861987620 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 37514)  | 
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MD 05748)  | 
| Enumeration Date | 2018-06-25 | 
| Last Update Date | 2018-06-25 |