| NPI | 1912293168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA 24454) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CA 24454) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2011-09-21 |