| NPI | 1962848077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 9684) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 9684) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2013-05-15 |