| NPI | 1053575605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MA 252080) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT192985) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT192985) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2012-07-13 |