| NPI | 1053831693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME11407) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX BP10059609) |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2022-09-30 |