| NPI | 1053467571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 34764) |
| Additional Taxonomies | 282E00000X Long Term Care Hospital (Licence: AZ 34764) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-07-27 |