| NPI | 1063901304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PR 21514) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21514) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 21514) | |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2023-03-01 |