| NPI | 1982639472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301007958) |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301007958) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2017-01-25 |