| NPI | 1912335852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 9729) |
| 103T00000X Psychologist (Licence: ND 495) | |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2015-08-04 |