| NPI | 1063772754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: KS 04-38473) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2016009344) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2016-05-05 |