| NPI | 1053511204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 47570) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.119067) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WY 16300A) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 55402-020) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2025-05-20 |