| NPI | 1053690669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: MO 2015004633) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MO 2011017409) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2021-11-08 |