| NPI | 1942383732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 364936) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 364936) |
| 103TR0400X Psychologist Rehabilitation (Licence: TX 364936) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2014-06-18 |