| NPI | 1962512913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 3393) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: AZ 3393) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 03393) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-10-12 |