| NPI | 1962921619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: ID PSY-203028) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ID PSY-203028) |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2017-11-19 |