| NPI | 1073817383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME 129772) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 18122) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2019-03-06 |