| NPI | 1992745483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301011902) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-04-27 |