| NPI | 1033798772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 34513) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: OH 57.251056) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2025-07-09 |