| NPI | 1912632597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP6813) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN LP6813) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2022-08-16 |