| NPI | 1053572859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 265100) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 390200000X) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2014-05-06 |