| NPI | 1053739300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 274526) |
| Additional Taxonomies | 174400000X Specialist |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 274526) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2020-09-08 |