| NPI | 1013438902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MT MED-PHYS-LIC-94923) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084N0600X (Licence: MT MED-PHYS-LIC-94923) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2022-04-06 |