| NPI | 1053786202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0024184204) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: VA 0024184204) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2023-11-08 |