| NPI | 1962559393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5314) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: PR 990) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2018-05-11 |